Transplant funding issue likely to heat up

Months after Arizona cut off Medicaid funding for some medical transplants as a budget-cutting move, the issue stands to heat up again as Gov. Jan Brewer and the Republican-led Legislature prepare to act on a state budget.

A spending plan approved by the Senate that is the starting point for current talks doesn’t restore funding, but a spokesman confirmed Friday that Gov. Jan Brewer is considering the transplant funding issue as part of revamping the state’s Medicaid program to help balance the state budget.

“That decision hasn’t been made,” Brewer spokesman Matt Benson said when asked about restoring transplant funding. He said the decision will hinge on making the state Medicaid program “sustainable for the long term.”

Brewer could tip her hand when she submits a Medicaid redesign proposal to federal officials in the coming week.

Meanwhile, Democrats haven’t let go of the issue, which stirred protests and heated rhetoric starting last October when a budget cut approved earlier last year took effect.

The cut, which saved the state a $1.2 million, eliminated state funding for several types of transplants that state officials said weren’t proven life-extenders. Transplant advocates dispute that.

The cuts left some transplant coverage intact but eliminated potential transplant funding for approximately 100 people enrolled in the state Medicaid program, the Arizona Health Care Cost Containment System.

One man denied coverage died of complications from preparations for a transplant for which he obtained private funding donated after news reports on the cutbacks. Hospital officials have said a second man’s death was apparently a result of the cutback.

The transplant funding issue has regularly surfaced during the legislative session that began in January, with Democrats contending that the money can easily be found in the state’s $8.5 billion budget despite the state’s continuing shortfalls.

Three different amendments to provide funding were unsuccessfully offered by Democrats during recent Senate action on a preliminary budget plan offered by Republicans. The amendments would have reduced the state’s auto theft program’s appropriation, cut state funding for health and dental insurance for Brewer and other statewide elected officials or repeal a sales-tax exemption for businesses’ expenses in calculating their taxes.

And last Monday, a House Democratic lawmaker decried inaction on options for transplant funding during a vote on an anti-abortion bill.

“These solutions are not even receiving a hearing,” said Rep. Katie Hobbs of Phoenix. “Two people have died and 98 more are waiting to die because of this deliberate policy choice. Where is the concern for life after it is born?”

Taking another tact, another Democratic lawmaker said Friday she’s quietly encouraging Republicans to have their budget include using private donations as state funding to draw down federal Medicaid matching dollars for transplants.

That’s a fallback from having the state use public funding, Rep. Anna Tovar of Tolleson acknowledged.

“This is finding a solution to put these people’s lives back on the list. I will do whatever I can,” said Tovar, herself a transplant recipient.

House Majority Leader Andy Tobin, R-Paulden, said some fellow Republicans are pressing for action on transplant funding when lawmakers consider changing the Medicaid system.

The issue is frustrating because while the federal government considers transplant coverage optional for states, the states must shoulder mandated spending for other Medicaid costs under the federal health care overhaul well before additional federal funding starts in 2014, Tobin said.

Meanwhile, Republican legislators “are getting beat up by our colleagues on the other side of the aisle” for cutting transplant funding, he added.

Tobin and Senate Majority Whip Steve Pierce, R-Prescott, said they hadn’t heard the transplant issue come up during budget negotiations.

Like Tobin, Pierce said there’s at least some Republicans want to act on transplant funding, and he also said “nothing is solidified.”

“I know that we in caucus and in meetings there have been discussions of different ways of solving the problem, then they’re reminded that the governor has said she’s already taken a hit on it.”

Brewer and legislators have kept the transplant issue relatively tamped down in recent months, said Stan Barnes, a Republican lobbyist and political commentator.

While the issue is difficult politically because it makes a budget cut “feel personal,” Brewer and GOP lawmakers have largely succeeded in casting it in context of the state’s overall budget troubles, said Barnes, a former state senator.

“It’s a testament to the public being informed and understanding (that) government is not omnipotent and we are in the midst of an actual fiscal crisis that hurts many people in many ways,” Barnes added.